Factors determining the actual received dose intensity in a program of multicyclic dose-intensive alternating chemotherapy with sequential stem cell support

Dose intensity has been related to clinical outcome in several solid tumors . We studied the influence of clinical and cellular parameters on dose inte nsity received in a series of 53 patients with metastatic breast cancer or advanced ovarian cancer. They received courses of cisplatin 120 mg/m(2) plu s etoposide 600 mg/m(2) alternating every 14 days with ifosfamide 8 g/m(2) plus paclitaxel 200-350 mg/m(2). Blood stem cell support was administered a fter every course except for the first one. Patients with excellent mobiliz ation underwent immunomagnetic selection of CD34+ cells. We found a signifi cant inverse correlation between the CD34+ cell dose infused and the delay for the administration of the next cycle. A CD34+ cell dose between 1.5 and 5 x 10(6)/kg per cycle was found to be feasible and was followed by a medi an delay of 1 day (not different from doses above 5 x 106/kg). Three factor s independently predicted the actually received dose intensity in a multipl e regression model (R-2 = 0.4): previous autologous transplantation, eligib ility for immunomagnetic selection (excellent response to mobilization) and median CD34+ cell dose received along the treatment. Copyright (C) 2001 S. Karger AG, Basel.